Abstract
We compared the clinical and microbiologic efficacy of two broad-spectrum combination antimicrobial regimens in the treatment of 148 patients with acute pelvic inflammatory disease. Patients were randomized to inpatient treatment with either cefoxitin and doxycycline (n = 75) or clindamycin and tobramycin (n = 73). These antibiotics were administered intravenously for at least 4 days, and up to 48 hours beyond defervescence. Patients were discharged on a regimen of oral doxycycline or clindamycin in accordance with the intravenous regimen to complete a total duration of therapy of 2 weeks. Neisseria gonorrhoeae (58%) and Chlamydia trachomatis (31%) were the microorganisms that were isolated most frequently from the genital tract of enrolled patients. At follow-up, N. gonorrhoeae was isolated in two patients, and C. trachomatis was isolated in none. The overall initial favorable response rate to combination antimicrobial therapy was 98.5% (130/132) in patients with uncomplicated pelvic inflammatory disease and 81% (13/16) in patients with pelvic inflammatory disease that was complicated by tuboovarian abscess. A > 70% decrease in abdominal tenderness score occurred in 89% of 111 patients within 6 weeks of hospital discharge. There were no significant differences between antibiotic treatment groups in any response categories or in toxicity. During the initial hospitalization, five patients (three with tuboovarian abscess, one with a pyosalpinx, and one with intractable acute and chronic pelvic inflammatory disease) required surgical intervention. These results support the recommendation to use broad-spectrum combination antimicrobial therapy for the treatment of acute pelvic inflammatory disease.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 849-858 |
| Number of pages | 10 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 164 |
| Issue number | 3 |
| State | Published - 1991 |
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Keywords
- acute salpingitis
- pelvic infections
- pelvic inflammatory disease
- sexually transmitted diseases
ASJC Scopus subject areas
- Medicine(all)
- Obstetrics and Gynecology
Cite this
Combination antimicrobial therapy in the treatment of acute pelvic inflammatory disease. / Landers, D. V.; Wolner-Hanssen, P.; Paavonen, J.; Thorpe, E.; Kiviat, N.; Ohm-Smith, M.; Green, J. R.; Schachter, J.; Holmes, K. K.; Eschenbach, D. A.; Sweet, Richard L.
In: American Journal of Obstetrics and Gynecology, Vol. 164, No. 3, 1991, p. 849-858.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Combination antimicrobial therapy in the treatment of acute pelvic inflammatory disease
AU - Landers, D. V.
AU - Wolner-Hanssen, P.
AU - Paavonen, J.
AU - Thorpe, E.
AU - Kiviat, N.
AU - Ohm-Smith, M.
AU - Green, J. R.
AU - Schachter, J.
AU - Holmes, K. K.
AU - Eschenbach, D. A.
AU - Sweet, Richard L
PY - 1991
Y1 - 1991
N2 - We compared the clinical and microbiologic efficacy of two broad-spectrum combination antimicrobial regimens in the treatment of 148 patients with acute pelvic inflammatory disease. Patients were randomized to inpatient treatment with either cefoxitin and doxycycline (n = 75) or clindamycin and tobramycin (n = 73). These antibiotics were administered intravenously for at least 4 days, and up to 48 hours beyond defervescence. Patients were discharged on a regimen of oral doxycycline or clindamycin in accordance with the intravenous regimen to complete a total duration of therapy of 2 weeks. Neisseria gonorrhoeae (58%) and Chlamydia trachomatis (31%) were the microorganisms that were isolated most frequently from the genital tract of enrolled patients. At follow-up, N. gonorrhoeae was isolated in two patients, and C. trachomatis was isolated in none. The overall initial favorable response rate to combination antimicrobial therapy was 98.5% (130/132) in patients with uncomplicated pelvic inflammatory disease and 81% (13/16) in patients with pelvic inflammatory disease that was complicated by tuboovarian abscess. A > 70% decrease in abdominal tenderness score occurred in 89% of 111 patients within 6 weeks of hospital discharge. There were no significant differences between antibiotic treatment groups in any response categories or in toxicity. During the initial hospitalization, five patients (three with tuboovarian abscess, one with a pyosalpinx, and one with intractable acute and chronic pelvic inflammatory disease) required surgical intervention. These results support the recommendation to use broad-spectrum combination antimicrobial therapy for the treatment of acute pelvic inflammatory disease.
AB - We compared the clinical and microbiologic efficacy of two broad-spectrum combination antimicrobial regimens in the treatment of 148 patients with acute pelvic inflammatory disease. Patients were randomized to inpatient treatment with either cefoxitin and doxycycline (n = 75) or clindamycin and tobramycin (n = 73). These antibiotics were administered intravenously for at least 4 days, and up to 48 hours beyond defervescence. Patients were discharged on a regimen of oral doxycycline or clindamycin in accordance with the intravenous regimen to complete a total duration of therapy of 2 weeks. Neisseria gonorrhoeae (58%) and Chlamydia trachomatis (31%) were the microorganisms that were isolated most frequently from the genital tract of enrolled patients. At follow-up, N. gonorrhoeae was isolated in two patients, and C. trachomatis was isolated in none. The overall initial favorable response rate to combination antimicrobial therapy was 98.5% (130/132) in patients with uncomplicated pelvic inflammatory disease and 81% (13/16) in patients with pelvic inflammatory disease that was complicated by tuboovarian abscess. A > 70% decrease in abdominal tenderness score occurred in 89% of 111 patients within 6 weeks of hospital discharge. There were no significant differences between antibiotic treatment groups in any response categories or in toxicity. During the initial hospitalization, five patients (three with tuboovarian abscess, one with a pyosalpinx, and one with intractable acute and chronic pelvic inflammatory disease) required surgical intervention. These results support the recommendation to use broad-spectrum combination antimicrobial therapy for the treatment of acute pelvic inflammatory disease.
KW - acute salpingitis
KW - pelvic infections
KW - pelvic inflammatory disease
KW - sexually transmitted diseases
UR - http://www.scopus.com/inward/record.url?scp=0026069113&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026069113&partnerID=8YFLogxK
M3 - Article
C2 - 1900663
AN - SCOPUS:0026069113
VL - 164
SP - 849
EP - 858
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 3
ER -